The "triple-plane technique" for breast augmentation

The Triple Plane, the Bra-Flap, and the Inverted Bra-Flap Modified Dual Plane Techniques for Breast Augmentation

BACKGROUND

Breast augmentation (BA) is a very common procedure performed for a wide range of indications. The short-term and long-term outcomes are strongly correlated with the choice of the correct implant pocket, which should be tailored to the anatomic features of the breast.

OBJECTIVES

The aim of this study was to report the safety and efficacy of the triple-plane technique and Bra-flap modified dual-plane techniques for BA.

METHODS

From January 1995 to January 2016, 605 patients underwent BA procedures that utilized the triple-plane technique or Bra-flap modified dual-plane techniques. Patient evaluation was performed preoperatively and postoperatively at 6 and 12 months and every 5 years thereafter. The occurrence of ptosis and implant malposition, as well as breast animation deformity, were assessed. Patient satisfaction was evaluated with the BREAST-Q Augmentation Module.

RESULTS

The average patient age was 39.3 years. The follow-up period ranged from 24 months to 20 years. The triple-plane technique was performed in 450 patients, the Bra-flap modified dual-plane technique in 97, and the inverted Bra-flap modified dual-plane technique in 58. No cases of double-bubble deformity or implant bottoming-out were observed. Regarding animation deformity, 209 patients presented with mild to moderate distortion, whereas no patients presented with severe distortion. The BREAST-Q questionnaire reported significant postoperative improvements in all scales.

CONCLUSIONS

In over 20 years of experience, the triple-plane technique has proven to be a reliable procedure that offers natural and long-lasting results. The Bra-flap and inverted Bra-flap modified dual-plane techniques are efficient options to expand the range of breast conditions treated.

LEVEL OF EVIDENCE: 4

Triple-plane technique for breast augmentation: solving animation deformities

An unpleasant consequence of subpectoral implant placement is the occurrence of animation deformities during pectoralis muscle contraction. This study aimed to review the results achieved for 524 patients undergoing the triple-plane technique with respect to loss of animation deformities. The evaluation was performed by a group of three plastic surgeons according to the Spear grading system for breast distortion using a 4-point scale. Of the 524 patients evaluated, 351 (67 %) were rated as grade 1 (no distortion), 156 (29.77 %) as grade 2 (mild distortion), 17 (3 %) as grade 3 (moderate distortion), and 0 (0 %) as 4 (severe distortion).The excellent results achieved can be explained by the horizontal sectioning of the major pectoralis muscle at the areola level to the sternal margin. In fact, it determines that superior to sectioning of the muscle, its activity remains normal, with a low degree of dynamic deformities. On the contrary, inferiorly, at the muscular-aponeurotic plane level, no activity is detected, with no resultant animation deformities.

LEVEL OF EVIDENCE IV

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